Prevalence of psychiatric symptoms in adults with mental retardation and challenging behaviour.

A team in Norway gave a short mental-health checklist to 165 adults with intellectual disability.

Staff who knew each adult well answered questions about anxiety, mood, and behavior.

The goal was to see if adults who show hitting, screaming, or self-injury also show more psychiatric symptoms.

Adults with challenging behavior were more likely to screen positive for anxiety and psychosis.

Surprisingly, anxiety was not tied to self-injury; only psychosis symptoms were.

The authors say we should add a quick psychiatric screen to every functional behavior assessment (FBA).

McCarthy et al. (2010) and Hilton et al. (2010) asked the same question but split the group into ID-only and ASD+ID. They found even higher psychopathology when autism is also present, backing up the call to screen.

Totsika et al. (2010) seems to disagree: in adults over 50, ASD+ID and ID-only showed the same psychiatric risk once daily-living skills were counted. The clash disappears when you see age and adaptive level as key variables—screen everyone, but expect different patterns by age.

Matson et al. (2004) came next and gave us PAS-ADD Checklist norms. Use those norms today to turn the target paper’s advice into a 5-minute routine.

You already list antecedents, behaviors, and consequences during an FBA. Add one page: the PAS-ADD Checklist. If psychosis or anxiety items are checked, refer for a psychiatric consult before you write the behavior plan. This simple step can stop weeks of failed interventions and needless medication hikes.